2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab

Abstract Background We aimed to study the predictive value of early two-dimensional echocardiography (2DE) speckle tracking (ST) for left ventricular ejection fraction (LVEF) changes during trastuzumab treatment for HER2-positive breast cancer. Methods HER2-positive breast cancer patients receiving...

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Autores principales:	Nathalie I. Bouwer, Crista Liesting, Marcel J. M. Kofflard, Jasper J. Brugts, Marc C. J. Kock, Jos J. E. M. Kitzen, Mark-David Levin, Eric Boersma
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	HER2-positive breast cancer Trastuzumab Cardiac MRI Speckle tracking echocardiography Strain imaging Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/bdf41c150bdb4ccc93397e29af0603f5
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spelling	oai:doaj.org-article:bdf41c150bdb4ccc93397e29af0603f52021-11-14T12:24:53Z2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab10.1186/s12947-021-00266-x1476-7120https://doaj.org/article/bdf41c150bdb4ccc93397e29af0603f52021-11-01T00:00:00Zhttps://doi.org/10.1186/s12947-021-00266-xhttps://doaj.org/toc/1476-7120Abstract Background We aimed to study the predictive value of early two-dimensional echocardiography (2DE) speckle tracking (ST) for left ventricular ejection fraction (LVEF) changes during trastuzumab treatment for HER2-positive breast cancer. Methods HER2-positive breast cancer patients receiving trastuzumab, with or without anthracycline, underwent 2DE-ST at baseline and after 3 and 6 months (m) trastuzumab. Cardiac magnetic resonance (CMR) imaging (with ST) was performed at baseline and 6 m. We studied the correlation between 2DE-ST- and CMR-derived global longitudinal strain (GLS) and global radial strain (GRS) measured at the same time. Additionally, we associated baseline and 3 m 2DE-ST measurements with later CMR-LVEF, and with cardiotoxicity, defined as CMR-LVEF < 45% and/or absolute decline > 10% during trastuzumab. Results Forty-seven patients were included. Median baseline LVEF was 60.4%. GLS measurements based on 2DE-ST and CMR showed weak correlation (Pearson’s r = 0.33; p = 0.041); GRS measurements were uncorrelated (r = 0.09; p = 0.979). 2DE-LVEF at baseline and 3 m, and 2DE-ST-GLS at 3 m were predictive of CMR-LVEF at 6 m. In contrast, the change in 2DE-ST-GLS at 3 m was predictive of the change in CMR-LVEF at 6 m, whereas the change in 2DE-LVEF was not. Importantly, the 11 patients who developed cardiotoxicity (28%) had larger 2DE-ST-GLS change at 3 m than those who did not (median 5.2%-points versus 1.7%-points; odds ratio for 1% difference change 1.81, 95% confidence interval 1.11–2.93; p = 0.016; explained variance 0.34). Conclusions Correlations between 2DE-ST and CMR-derived measurements are weak. Nevertheless, ST-measurements appeared useful to improve the performance of 2DE in predicting LVEF changes after 6 m of trastuzumab treatment.Nathalie I. BouwerCrista LiestingMarcel J. M. KofflardJasper J. BrugtsMarc C. J. KockJos J. E. M. KitzenMark-David LevinEric BoersmaBMCarticleHER2-positive breast cancerTrastuzumabCardiac MRISpeckle tracking echocardiographyStrain imagingDiseases of the circulatory (Cardiovascular) systemRC666-701ENCardiovascular Ultrasound, Vol 19, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	HER2-positive breast cancer Trastuzumab Cardiac MRI Speckle tracking echocardiography Strain imaging Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	HER2-positive breast cancer Trastuzumab Cardiac MRI Speckle tracking echocardiography Strain imaging Diseases of the circulatory (Cardiovascular) system RC666-701 Nathalie I. Bouwer Crista Liesting Marcel J. M. Kofflard Jasper J. Brugts Marc C. J. Kock Jos J. E. M. Kitzen Mark-David Levin Eric Boersma 2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab
description	Abstract Background We aimed to study the predictive value of early two-dimensional echocardiography (2DE) speckle tracking (ST) for left ventricular ejection fraction (LVEF) changes during trastuzumab treatment for HER2-positive breast cancer. Methods HER2-positive breast cancer patients receiving trastuzumab, with or without anthracycline, underwent 2DE-ST at baseline and after 3 and 6 months (m) trastuzumab. Cardiac magnetic resonance (CMR) imaging (with ST) was performed at baseline and 6 m. We studied the correlation between 2DE-ST- and CMR-derived global longitudinal strain (GLS) and global radial strain (GRS) measured at the same time. Additionally, we associated baseline and 3 m 2DE-ST measurements with later CMR-LVEF, and with cardiotoxicity, defined as CMR-LVEF < 45% and/or absolute decline > 10% during trastuzumab. Results Forty-seven patients were included. Median baseline LVEF was 60.4%. GLS measurements based on 2DE-ST and CMR showed weak correlation (Pearson’s r = 0.33; p = 0.041); GRS measurements were uncorrelated (r = 0.09; p = 0.979). 2DE-LVEF at baseline and 3 m, and 2DE-ST-GLS at 3 m were predictive of CMR-LVEF at 6 m. In contrast, the change in 2DE-ST-GLS at 3 m was predictive of the change in CMR-LVEF at 6 m, whereas the change in 2DE-LVEF was not. Importantly, the 11 patients who developed cardiotoxicity (28%) had larger 2DE-ST-GLS change at 3 m than those who did not (median 5.2%-points versus 1.7%-points; odds ratio for 1% difference change 1.81, 95% confidence interval 1.11–2.93; p = 0.016; explained variance 0.34). Conclusions Correlations between 2DE-ST and CMR-derived measurements are weak. Nevertheless, ST-measurements appeared useful to improve the performance of 2DE in predicting LVEF changes after 6 m of trastuzumab treatment.
format	article
author	Nathalie I. Bouwer Crista Liesting Marcel J. M. Kofflard Jasper J. Brugts Marc C. J. Kock Jos J. E. M. Kitzen Mark-David Levin Eric Boersma
author_facet	Nathalie I. Bouwer Crista Liesting Marcel J. M. Kofflard Jasper J. Brugts Marc C. J. Kock Jos J. E. M. Kitzen Mark-David Levin Eric Boersma
author_sort	Nathalie I. Bouwer
title	2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab
title_short	2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab
title_full	2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab
title_fullStr	2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab
title_full_unstemmed	2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab
title_sort	2d-echocardiography vs cardiac mri strain: a prospective cohort study in patients with her2-positive breast cancer undergoing trastuzumab
publisher	BMC
publishDate	2021
url	https://doaj.org/article/bdf41c150bdb4ccc93397e29af0603f5
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2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab

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